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Darden Student Profiles: Changing Healthcare in Burundi

I recently sat in on a speech by Ed Freeman, where he shared about how to discover Inspiration. A particularly important point he made is to look for inspiration among those around us. For Ed, inspiration came from within his family.
As we think about the Darden Family, it seemed appropriate to look for inspiration within our family. With that in mind, I'm excited to invite our first student speaker to share a bit about his story.

Jonathan,
in 2008 you co-founded LifeNet International in order to deliver health
solutions to the poor in Burundi.

Can
you share a bit about what motivated you to launch this organization?

We
started LifeNet out of a desire to better serve the global poor and for me,
personally, an entrepreneurial desire to be part of a start-up. Microfinance
had done wonders in helping the poor gain sustenance in food, but little had
been done in healthcare. We wanted to create something that would bring healing
to the poor.

I
was working in investments at the time, when a mentor approached me with his
idea to apply business-thinking to healthcare for the poor. We wanted to serve
the poor in a way that would be sustainable (financially) and scalable (would
impact a large number of people).

Launching
a business is Burundi is an unusual task. What challenges did you face in
bringing LifeNet to fruition?

There
were two key lessons I learned in Burundi: fail fast, and persevere. Within
three months of our launch we had completely failed in our idea for nurse
entrepreneurs. The government regulations significantly restricted innovation
in the delivery platform and many of the local nurses had much lower levels of
education than we ever imagined. But we failed fast and learned faster. Within
a few weeks we had another pilot launched focused on franchising existing
clinics and a few months later launched our final major pilot that further
honed our idea to focus on faith-based clinics, which were strategically
significant in the country.

Our
final model was a conversion franchise for faith-based clinics. That means, we
took existing clinics and incorporated them into our franchise network to
deliver nursing and businesses education, quality control, and medicine supply.

Official
NGO registration with the government is required to scale your organization,
import goods and the like. This process took me 16 months to complete because
we refused to pay bribes. I met with everyone from the Minister of Health to
the Permanent Secretary of Foreign Affairs to every administrative assistant, I
believe, in the entire government (so perhaps not everyone in the
government, but I did meet with a LOT of people to gain our final approval).
But all the work, all the setbacks, taught me a very important lesson in not
giving up.

How
has LifeNet impacted the health system in Burundi? What challenges remain in
improving healthcare delivery?

It’s
incredibly exciting to see our work continue to grow. We’re now in 40 clinics
and hospitals in Burundi and our network sees nearly 50,000 patient visits
every month! In our first 10 clinic partners (with one year of partnership)
we’ve improved the quality of care by 63% on average. In a country of 9 million
people, we feel like there’s a real chance to impact their well-being.

The
challenges ahead are significant. We’re still trying to increase the financial
sustainability of our operations through medicine importation, but that’s a
very difficult business in a developing country. There are also significant
infrastructure and educational constraints that are major problems and not
quickly fixed.

What
prompted you to come to Darden for your MBA?

After
nearly three years in Burundi our project was beginning to shift from our pilot
stage to scaled growth. I felt that this was the right time for me to make a
personal transition back to the US and that’s when I applied to Darden.

My
work with LifeNet taught me the power of business-thinking to create value in
the nonprofit space but I was always wanted something more. I saw telecoms in
Burundi that were making millions in profit and yet creating tremendous social
value that nobody seemed to recognize. And that’s what I wanted to do. Create
businesses that generated both economic and social forms of capital and I saw
Darden as a place where I could explore these ideas.

Any
advice for those planning to enter the social entrepreneurship space?

I
would take Ed Freeman’s class and begin to question the social entrepreneurship
heuristic. I think we should start with recognizing the problem to be solved
and then trying to understand what forms of capital are required to solve it –
is it philanthropic capital, patient capital, economic capital, or something
else? There are a number of great nonprofits that apply business-thinking and a
(very large) number of great businesses that generate social value and each are
solving meaningful problems.

If
you are interested in solving complex problems using non-traditional capital –
philanthropic or otherwise - core business skills are crucial. My time spent in
investments prior to LifeNet was invaluable. I knew how to put together a pitch
book, which helped us communicate to donors. I knew how to build a financial
model, which enabled us to make mid-sized loans to local clinics. So,
consulting and investment backgrounds can be a huge help. Marketing also plays
a big role. A good friend is an exceptional marketer and I was constantly
soliciting his help.

The
last qualifier is that none of this is any good unless you’re on the ground. Be
willing to go move for two or three or five years to a crazy place and see what
happens. You can’t learn empathy from a case. Really invest yourself in what
you are doing, go co-create with your customer, and deliver a product that
changes the world.

******************************************

Jonathan O’Connor is first-year MBA student at the Darden
Graduate School of Business. Prior to Darden, he was a co-founder at LifeNet
International, a nonprofit that improves performance of primary care clinics
and hospitals in Burundi, East Africa. Prior to launching LifeNet, he worked as
an investment analyst with CNL Real Estate Advisors. During his time
with CNL, he helped to originate private placement real estate funds for
syndication to the retail equity markets. Prior to joining CNL, Jonathan was
awarded a fellowship of the Trinity Forum Academy, a leadership academy
based outside of Washington, DC. Jonathan will spend his summer as an associate
at New City Capital, a private-equity firm based in Charlottesville, Virginia.